The Ghost Map

Author: Steven Johnson
Year published: 2006
Category: nonfiction (history of science); a true medical mystery

The Ghost Map by Steven Johnson is “the story of London’s most terrifying epidemic and how it changed science, cities, and the modern world.”  The ‘epidemic’ was actually a sudden, severe outbreak, of cholera, in 1854. Whether this infectious disease event was London’s “most terrifying”–more than, say, the Black Death–is another question.

Despite the hyperbole on the cover, this book is a highly readable narrative that tells the events in London’s neighborhood around the Broad Street pump, when entire families went from perfect health to death in less than a day.  This history of science tale is combined with a perspective on the rise of modern cities.  The Ghost Map is a story about an unsustainable concentration of humans suffocating in their own waste; about a microbe that took advantage of the situation; and about two men who had the pluck and intellectual capacity to find the cause of the disease.  In the process, Dr. John Snow (a true polymath genius) and Reverend Henry Whitehead established the foundations of modern epidemiology, and in some ways made the whole human experiment with city living sustainable.

Author Steven Johnson fleshes out the cholera story with fascinating (and repugnant) details about the London of Dickens’ time, before sewers or garbage trucks.  He describes “the unsolved problems of packing so many people together”, and how human scavengers such as the so-called night soil men collected and removed excrement and everything else produced by a dense population.  (The images you get in your mind will linger a long while.)  He brings in some intellectual history on the debate whether “miasma” (bad air) or “contagion” (human contact) led to disease.  (Both sides were wrong on cholera; it spreads in the water.)  The reader also gets a biography of John Snow and a bit about the origin of general anesthesia.

About half of this book is about medicine and one of the great mysteries solved by epidemiology.  The remainder is about cities: how they came to be, how they nearly died, what drives them to persist, and what the future of cities might be.  The author mixes all of this together effectively.  Only toward the very end of the book does he wander too far. Snow’s map, a convincing visual representation of a huge amount of data that is a landmark in graphic design, sends the writer off-topic.  Then in the epilogue, he wastes words in a fanciful attempt to unite the cholera story with the Internet, terrorism, and some not-very-factual extrapolations about what science can and cannot do.  Skip this last chapter, but be entertained and enlightened by the rest.

From the publisher:

It’s the summer of 1854, and London is just emerging as one of the first modern cities in the world. But lacking the infrastructure-garbage removal, clean water, sewers-necessary to support its rapidly expanding population, the city has become the perfect breeding ground for a terrifying disease no one knows how to cure. As the cholera outbreak takes hold, a physician and a local curate are spurred to action-and ultimately solve the most pressing medical riddle of their time.
In a triumph of multidisciplinary thinking, Johnson illuminates the intertwined histories of the spread of disease, the rise of cities, and the nature of scientific inquiry, offering both a riveting history and a powerful explanation of how it has shaped the world we live in.

If you like The Ghost Map, you might like:
Flu by Gina Kolata; Deadly by Julie Chibbaro; Stiff by Mary Roach; The Hot Zone by Richard Preston; Bad Science by Ben Goldacre